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. 2019;39(2):35-39.

The Effect of Turf Toe Injuries on Player Performance in the National Football League

Andrew Tran  1 , Jason Kappa  1 , Evan Smith  1 , Michael Hoy  2 , Jacob Farrar  2 , Avinash Chandran  3 , Rajeev Pandarinath  1
Affiliations

The Effect of Turf Toe Injuries on Player Performance in the National Football League

Andrew Tran et al. Iowa Orthop J. 2019.

Abstract

Background: "Turf toe" results from hyperdorsiflexion of the first metatarsophalangeal joint, injuring the plantar capsuloligamentous complex. We hypothesized that National Football League (NFL) player performance following turf toe injury would decrease in comparison to controls at the same position.

Methods: Demographics, return to play, and season performance data on players sustaining turf toe injuries in the NFL from 2010-2015 were collected. An Offensive Power Rating (OPR=[total yards/10]+[total touchdowns x6]) or Defensive Power Rating (DPR=total tackles+[total sacks x2]+[total interceptions x2]) was calculated for each player. Control data were collected for NFL players in 2013 with no history of turf toe injury. Statistical analysis was performed using Wilcoxon Rank Sum tests.

Results: Twenty-four injured players and 436 controls were included. Nineteen players returned to play within the regular season of injury (mean 36.7 ± 28.9 days). Seventeen players were removed from team injury reports for turf toe within the regular season (mean 42.6 ± 26.2 days). Three players required season-ending surgery. Comparison of 1-year post- versus pre-injury revealed an insignificant median OPR difference (-18.9 IQR -43.4 to 10.3 vs. control -12.2 IQR -46.2 to 47.7, p = 0.328) and median DPR difference (-1.0 IQR -26.0 to 17.0 vs. control 2.0 IQR -15.0 to 18.0, p = NA). Comparison of 2-year data revealed no significant median OPR difference (-32.6 IQR -122.2 to 1.0 vs. control -20.7 IQR -72.6 to 44.7, p = 0.327) and median DPR difference (-5.0 IQR -19.0 to 6.0 vs. control -4.5 IQR -22.0 to 12.5, p= NA).

Conclusions: Turf toe results in significant loss of playing time. Despite the long recovery period, NFL players have similar performance following injury compared to controls. The effect of turf toe injuries on performance is variable.Level of evidence: IV.

Keywords: football; performance; sports; turf toe.

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Conflict of interest statement

Disclosures: The authors report no potential conflicts of interest related to this study.

Figures

Figure 1
Figure 1
Number of days (a) to return to play and (b) until removed from the injury report for all turf toe injured players. FS denotes players who not return until the following season.
Figure 2
Figure 2
Median offensive power rating and interquartile range of injured players vs controls per season.
Figure 3
Figure 3
Median defensive power rating and interquartile range of injured players vs controls per season.
See this image and copyright information in PMC

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